Key result
S-ICD implantation was successful in all 11 patients with an average hospitalization cost of 21,014 EUR, providing a viable alternative to transvenous ICDs for patients without pacing requirements.
Why the study?
What are the adverse events, device function, and hospitalization costs associated with S-ICD implantation in patients with standard ICD indications?
Observational (n=11)
No
What are the adverse events, device function, and hospitalization costs associated with S-ICD implantation in patients with standard ICD indications?
S-ICD implantation is a viable alternative to transvenous ICD with an average hospitalization cost of 21,014.29 EUR in a Polish center.
Single-center costs may guide planning; leaves open comparative safety versus transvenous ICDs.
BACKGROUND: The recent introduction of an entirely subcutaneous implantable cardioverter-defibril-lator (S-ICD) represents an important progress in the defibrillation technology towards a less invasive approach. This is a single-center observational study of S-ICD implantations in Poland. METHODS: The S-ICD was implanted in 11 patients with standard indications for an ICD. Patients in whom the device was implanted were evaluated for adverse events and device function at hospital discharge. All hospitalization costs were calculated and summed up for all patients. Costs were divided into following categories: medical materials, pharmaceuticals, operating theatre staff, cardiology depart-ment staff, laboratory tests, non-laboratory tests and additional non-medical costs. RESULTS: The mean age of patients was 51.6 ± 16.4 years, 9 were men and 2 were women. Four pa-tients had atrial fibrillation as the basal rhythm, 1 patient had atrial flutter and 6 patients had sinus rhythm. All patients had at least one condition that precluded the use of a traditional ICD system or the S-ICD was preferred due to other conditions, i.e. a history complicated transvenous ICD therapy (18%), anticipated higher risk of infection (27%), lack or difficult vascular access (18%), young age and anticipated high cumulated risk of lifetime device therapy (36%). The mean duration of the im-plantation procedure was 2 h. One patient developed a postoperative pocket hematoma. Mean total time of hospitalization was 28 (6-92) days. Average cost of hospitalization per patient was 21,014.29 EUR (minimal = 19,332.71 EUR and maximal = 24,824.14 EUR). CONCLUSIONS: S-ICD implantation appears to provide a viable alternative to transvenous ICD, espe-cially for patients without pacing requirements.
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Grabowski et al. (2018) conducted an observational in High risk of sudden cardiac death requiring ICD (n=11). Subcutaneous implantable cardioverter-defibrillator (S-ICD) was evaluated on Procedural success, adverse events, and hospitalization costs. S-ICD implantation was successful in all 11 patients with an average hospitalization cost of 21,014 EUR, providing a viable alternative to transvenous ICDs for patients without pacing requirements.
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